Columns » Ernest Dumas



Jesus found something blessed about poor people, even promising them the kingdom of God, and he was always admonishing his disciples to feed and tend to them when they were sick. He reviled the rich and the uncharitable.

But Jesus didn't know poor people, or at least lots of them, like the state and federal governments know them. Monday, an official of the Trump administration joined with Governor Hutchinson and his human services chief to announce that poor people in Arkansas who don't hold a fairly steady job do not deserve the government-subsidized medical coverage that now is supplied to 1.5 million Arkansans, a little more than half the people in the state. With Washington's blessing, the state will start lopping them off the insurance rolls in June. If they can't meet bureaucratic standards for self-help, the government considers them undeserving of compassion.

The officials said they were going to take away health insurance from up to 90,000 people for their own good. If the government withholds medical care, see, then the lazy poor will be forced to buck up, do what it takes to get a job — maybe move from their lifeless communities to Northwest Arkansas where jobs are more plentiful — and then they will feel better about themselves and become proud Americans.

That has been Hutchinson's reasoning and it was echoed by Seema Verma, President Trump's Medicare and Medicaid administrator, who flew down to share the glory of the moment with Hutchinson. Before the president tapped her to run the government health programs, Verma was a health-policy consultant who helped Republicans find ways to shrink coverage under the Affordable Care Act.

There is no evidence that the carrot and stick will work. The world has centuries of failing experience with forcing "able-bodied" but reputedly lazy people to find and hold regular jobs. England's poor law, enacted in 1601, required communities to collect taxes and distribute aid to the poor but only to those who were totally impotent to support themselves. The "able bodied" got no help. Deciding who was not able bodied proved hard — those disabled only by severe physical problems or those with mental incapacities or illnesses? And what if there were no jobs to be had that they could do? Two centuries later, the Brits tried other rules, like "nobody who tipples in the alehouse will get poor relief."

We have sharper bureaucrats now. The Department of Human Services has come up with a raft of rules defining who is worthy of the state's humanity. To keep insurance, a poor woman must get on her computer and make a detailed electronic report to DHS every two months, including proof of 80 hours of "work activity" every month or that she has other conditions that would exempt her, like pregnancy or disabilities that make it impossible to work. No jobs you can do is not an excuse. If you miss the threshold a couple of months, your coverage is canceled and you can't get it again until the next year, even if you land a good job.

Bureaucratic hurdles, a hassle for the most industrious people, will be enormous. They have driven tens of thousands off the rolls the past two years. You have not encountered a bureaucracy until you deal with the Department of Human Services.

But Hutchinson says not to worry. The worthy will get jobs this time, keep their health care and hold their heads higher.

Actually, this is not a philosophical issue over biblical and moral teachings but a political one. Unless Hutchinson demonstrates sufficient inhumanity, a legislature controlled by his party will halt the whole Medicaid program he calls Arkansas Works by withholding the appropriation of state and federal funds. The sudden loss of the program would not only throw 300,000 people into a crisis, but threaten the financial stability of the state government by withdrawing hundreds of millions of dollars a year from the state treasury and the economy. A sizable minority of Republican legislators wants that to happen. They believe the undeserving poor are cashing in everywhere — Medicaid programs, food stamps, subsidized housing, nutrition programs for the elderly, temporary welfare assistance — and stopping Arkansas Works will be one victory.

The legislature held up voting on the Human Services appropriation until Hutchinson could get the Trump administration to give him the work waiver to Obamacare. We will see this week whether he reached the meanness threshold.

Hutchinson had linked the work waiver to an even harsher measure. He asked Washington to allow Arkansas to end Medicaid for 60,000 people with incomes higher than the poverty line (about $12,000 a year), but Verma brought Hutchinson no such good news. Obamacare makes people up to 138 percent of poverty eligible for coverage.

He may yet get that waiver, too, although it seems to be even a clearer violation of the law than the work waiver. Waivers are not supposed to be granted if they violate the major purposes of the law, which are to bring health coverage to more Americans, not fewer. What would Jesus do?

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